title: Three-dimensional volumetric computed tomographic scoring as an objective outcome measure for chronic rhinosinusitis: clinical correlations and comparison to Lund-Mackay scoring.
abstract: BACKGROUND
  We aimed to test the hypothesis that three-dimensional (3D) volume-based scoring of computed tomography (CT) images of the paranasal sinuses was superior to Lund-Mackay CT scoring of disease severity in chronic rhinosinusitis (CRS). We determined correlation between changes in CT scores (using each scoring system) with changes in other measures of disease severity (symptoms, endoscopic scoring, and quality of life) in patients with CRS treated with triamcinolone.
  
  
  METHODS
  The study group comprised 48 adult subjects with CRS. Baseline symptoms and quality of life were assessed. Endoscopy and CT scans were performed. Patients received a single systemic dose of intramuscular triamcinolone and were reevaluated 1 month later. Strengths of the correlations between changes in CT scores and changes in CRS signs and symptoms and quality of life were determined.
  
  
  RESULTS
  We observed some variability in degree of improvement for the different symptom, endoscopic, and quality-of-life parameters after treatment. Improvement of parameters was significantly correlated with improvement in CT disease score using both CT scoring methods. However, volumetric CT scoring had greater correlation with these parameters than Lund-Mackay scoring.
  
  
  CONCLUSIONS
  Volumetric scoring exhibited higher degree of correlation than Lund-Mackay scoring when comparing improvement in CT score with improvement in score for symptoms, endoscopic exam, and quality of life in this group of patients who received beneficial medical treatment for CRS.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN.
authors.forename: John F
authors.initials: JF
authors.lastname: Pallanch
authors.forename: Lifeng
authors.initials: L
authors.lastname: Yu
authors.forename: David
authors.initials: D
authors.lastname: Delone
authors.forename: Rich
authors.initials: R
authors.lastname: Robb
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
authors.forename: Jon
authors.initials: J
authors.lastname: Camp
authors.forename: Phil
authors.initials: P
authors.lastname: Edwards
authors.forename: Cynthia H
authors.initials: CH
authors.lastname: McCollough
authors.forename: Jens
authors.initials: J
authors.lastname: Ponikau
authors.forename: Amy C
authors.initials: AC
authors.lastname: Dearking
authors.forename: John
authors.initials: J
authors.lastname: Lane
authors.forename: Andrew
authors.initials: A
authors.lastname: Primak
authors.forename: Aaron
authors.initials: A
authors.lastname: Shinkle
authors.forename: John
authors.initials: J
authors.lastname: Hagan
authors.forename: Evangelo
authors.initials: E
authors.lastname: Frigas
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Ocel
authors.forename: Nicole
authors.initials: N
authors.lastname: Tombers
authors.forename: Rizwan
authors.initials: R
authors.lastname: Siwani
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Orme
authors.forename: Kurtis B
authors.initials: KB
authors.lastname: Reed
authors.forename: Nivedita
authors.initials: N
authors.lastname: Jerath
authors.forename: Robinder
authors.initials: R
authors.lastname: Dhillon
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kita
mesh_terms: D000328:Adult; D002908:Chronic Disease; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012220:Rhinitis / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000000981:diagnostic imaging*
keywords: Lund-Mackay; computed tomography; computer-assisted image analysis; endoscopy; quality of life